Lymphangiectasia

Issue DescriptionLymphangiectasia is an intestinal disease of
dogs, and more rarely humans, characterized by lymphatic vessel
dilation, chronic diarrhea and loss of proteins such as serum albumin
and globulin. It is considered to be a chronic form of protein-losing
enteropathy.Other NamesIntestinal Lymphangiectasia

CausesThe most common cause of lymphangiectasia is
congenital malformation of the lymphatics. Secondary lymphangiectasia
may be caused by granulomas or cancer causing lymphatic obstruction,
or increased central venous pressure (CVP) causing abnormal lymph
drainage. Increased CVP can be caused by pericarditis or right-sided
heart failure. Inflammatory bowel disease can also lead to
inflammation of the lymphatics and lymphangiectasia through migration
of inflammatory cells through the lymphatics.

SymptomsThe symptoms of this intestinal disorder
include weight loss, chronic diarrhea, vomiting and bloating from
fluid accumulation in the abdomen. Not all cases present symptoms of
diarrhea and vomiting. Clinical signs can vary from mild signs,
lethargy, flatulence, edema to emaciation. In some cases fluid
accumulation in the chest (pleural effusion) may lead to the secondary
symptoms of life-threatening respiratory difficulty.

DiagnosisBlood test results can help diagnose Intestinal
Lymphangiectasia, especially if no clues of the condition are present.
Results can show a low lymphocyte count, low cholesterol and low
albumin level. The albumin is the main blood protein that transports
biochemicals. The albumin keeps water in the bloodstream. If the
vasculature no longer holds the water, the leakage causes fluid
accumulation in the tissue, chest or abdomen. A biochemical profile
can help determine kidney, liver, protein and electrolyte status.
Urinalysis is often normal and can rule out kidney disease. Other
tests include fecal exams, chest and abdominal x-rays, abdominal
ultrasound and gastroduodenoscopy. The veterinarian may conduct an
intestinal biopsy either through surgery or endoscopy to determine
cause and treatment.

TreatmentTreatment of Intestinal Lymphangiectasia can
include treating the inflammation, dietary management and diuretics,
oncotic agents, and other options, including surgery. Treatment varies
with consideration of the type of signs and severity of the disorder.
Pets suffering from severe vomiting and/or diarrhea may receive
aggressive treatment and stabilization in a hospital. Patients with
milder signs may receive close monitoring and treatment as
outpatients.

Veterinarians may treat inflammation with corticosteroids,
anti-inflammatory drugs, such as prednisone and/or azathioprine.
Dietary management can help reduce pressure in the lymph vessels to
reduce lymph. The diet can include adding medium chain triglycerides
oil (MCT) to provide a source of calories with a low fat diet.
Diuretics can increase urination and reduce fluid accumulation.
Tapping the body cavity and suctioning the fluid is another option.
Oncotic agents (plasma, dextrans, hetastarch) help with the normal
fluid distribution.

Follow-up can include signs of activity
level, body weight, appetite and clinical signs of pleural effusion,
ascites and edema. Tests can include serum protein level.

Follow UpUnfortunately, this condition isn't something
that can be prevented. Managing the condition once it occurs is the
only option.

Limit exercise while your canine is
recovering. Encourage him to rest as much as possible. Keeping him on
a leash during bathroom breaks can help cut down on excess activity.